Wound Care

When you leave the hospital, your wound will require little special care. You may shower. The staples or strips which are on it can get wet and my be removed when you come to the office for your first visit. The wound my be left uncover or covered, whichever is more comfortable.

Getting Your Nutrients

	For the next four to six weeks you will be consuming only liquids and blenderized foods in order to allow your surgery to heal properly and to start you on your way to a healthier weight.
	Choose your foods wisely there is limited space! Choose foods which are nutrient dense not foods high in calories such as ice cream and chips.
	Take your vitamin/mineral supplements everyday. Do not take them with tea or coffee. This may upset your stomach and decrease absorption of minerals. besides, these caffeine stimulates appetite.
	All obesity surgery patients should take "2" children's vitamins/minerals with iron twice each day. Examples include Children's Chewable Centrum with Iron, Flintstones Complete with Iron, or other generic chewable brands.
	Gastric Bypass patients may be required to take Foltrin, Niferex Forte, or Slow FE as prescribed, on a daily basis. This will be determined by blood tests we will do after surgery. This may turn your stool black, and may be constipation, but the alternative is anemia!

Protein

It is important for the healing process and the weight loss process that you include a variety of foods containing adequate protein. Many of the recipes contained in this booklet are particularly good sources of protein. Those recipes are noted with an asterisk*.  When you fill up on foods containing protein, your body doesn't destroy your own protein stores, besides, it leaves less room in your stomach for fats and sweets.

Fluids

Drink at least one quart (4 Cups) of low calorie fluid per day such as water, crystal light or diet Kool-Aid. Avoid caffeine as it may interfere with the absorption of minerals and it stimulates appetite. Some patients carry a sports bottle filled with cool water or sugar free beverage around from which to freely sip during the day.

Other Foods

No carbonated beverages.  It will stretch the pouch! Not chewing gum. It causes gas, and if swallowed, could block your pouch outlet. Avoid stringy vegetables such as celery, rhubarb and fresh string beans, and apple and grape skins. NO CORN!!!!!!!!

Planning and Timing of Meals

	Eat three meals per day. Purchase juice glasses (4-6 ounces) and small cereal bowls to eat your pureed foods. Eat slowly to reduce discomfort, and take advantage of the satiety reflex. Put your eating utensil down on the table between each bite and count to 25 before you pick it back up for the nest bite.  Take 30- 45 minutes for a meal. Consume liquids between meals, 20 minutes after or before and remember, thin liquids, such as water and thin juices will pass through more quickly, but thicker liquids such as nectars and dairy will pass through more slowly.
	Take the time to plan your meals. You can eat with your family and frequently eat what your family is eating if you plan carefully. Blend entrees then reheat in a small saucepan or microwave. Remember if reheating in a microwave, mix well to distribute the hot areas of food as microwaves heat irregularly.  Each person is individual in the amount of food and size or meal they can tolerate. It may take some trial and error on your part but as a rule of thumb, consume only 1 ounce of food every 15 minutes and no more that 6 ounces of liquids in 20-30 minutes. Put your utensil down next to your plate after each bite' count to twenty-five after swallowing before you pick it up to get the next bite. If you are feeling full, STOP, and don't take another bite until that feeling passes.
	Do not lie down soon after eating or drinking. Try to remain upright for at least two hours after consuming anything to assist in the passage into the lower stomach. Don't do other activities while eating. Concentrate on your meal. Be aware of what you have chosen to eat.

Cooking and Preparation Tips

	Do not use the microwave to cook meats as they heat incompletely increasing the possibility for contamination. You also may get better results if you boil fibrous foods such as vegetables and cook meats such as chicken in a inch of water. Blenderized or process the vegetables in the cooking water to get all the nutrients and flavor.
	Another alternative to preparing poultry is purchasing ground chicken or turkey. Select only poultry breast or packages marked 15% of fat or less to reduce your fat intake and always drain the meat prior to blendarizing.
	Make sure your foods can be sipped through a straw but serve your entree in a bowl and eat with a spoon! Avoid distractions during mealtimes like television and pay attention to your rate of consumption. Enjoy your food. Eating is an important self-care activity and deserves time and attention.

Troubleshooting

	If your are having problems with pain, vomiting, and distention, try the following: stop eating for 2 hours start slowly with water, chamomile or the  caffeine free tea increase to other foods as tolerated; for example, try juice then skim milk walk;massag4e your stomach gently if vomiting persists, call the office
	When pain, vomiting and distension occur, note the type and amount of food you ate prior to onset. Keep track in a log and make an appoi8ntment with the dietitian for a consultation.